Implementation and role of device management Solutions to the end users

This research is based on consumer complaints with respect to recently purchased consumer electronics. This research document will investigate the instances of development and device management as a tool used to aid consumer and manage consumer’s mobile products in order to resolve issues in or before the consumers is aware one exists. The problem at the present time is that mobile devices are becoming very advanced pieces of technology, and not all manufacturers and network providers have kept up the support element of End users. As such, the subject of the research is to investigate how device management could possibly be used as a method to promote research and development of mobile devices, and provide a better experience for the consumer. The wireless world is becoming increasingly complex as revenue opportunities are driven by new and innovative data services. We can no longer expect the customer to have the knowledge or ability to configure their own device. Device Management platforms can address the challenges of device configuration and support through new enabling technologies. Leveraging these technologies will allow a network operator to reduce the cost of subscriber ownership, drive increased ARPU (Average Revenue per User) by removing barriers to adoption, reduce churn by improving the customer experience and increase customer loyalty. DM technologies provide a flexible and powerful management method but are managing the same device features that have historically been configured manually through call centers or by the end user making changes directly on the device. For this reason DM technologies must be treated as part of a wider support solution. The traditional requirement for discovery, fault finding, troubleshooting and diagnosis are still as relevant with DM as they are in the current human support environment yet the current generation of solutions do little to address this problem. In the deployment of an effective Device Management solution the network operator must consider the integration of the DM platform, interfacing with many areas of the business, supported by knowledge of the relationship between devices, applications, solutions and services maintained on an ongoing basis. Complementing the DM solution with published device information, setup guides, training material and web based tools will ensure the quality of the customer experience, ensuring that problems are completely resolved, driving data usage by focusing customer education on the use of the wireless service In this way device management becomes a tool used both internally within the network or device vendor and by the customer themselves, with each user empowered to effectively manage the device without any prior knowledge or experience, confident that changes they apply will be relevant, accurate, stable and compatible. The value offered by an effective DM solution with an expert knowledge service will become a significant differentiator for the network operator in an ever competitive wireless market. This research document is intended to highlight some of the issues the industry faces as device management technologies become more prevalent, and offers some potential solutions to simplify the increasingly complex task of managing devices on the network, where device management can be used as a tool to aid customer relations and manage customer’s mobile products in order to resolve issues before the user is aware one exists. The research is broken down into the following, Customer Relationship Management, Device management, the role of knowledge with the DM, Companies that have successfully implemented device management, and the future of device management and CRM. And it also consists of questionnaires aimed at technical support agents and mobile device users. Interview was carried out with CRM managers within support centre to further the evidence gathered. To conclude, the document is to consider the advantages and disadvantages of device management and attempt to determine the influence it will have over customer support centre, and what methods could be used to implement it.

Strategies for the use of PIMEX and other video exposure monitoring methods. : Final report from sub-project “implementation strategies” within the HERIVIS project

Video exposure monitoring (VEM) is a group of methods used for occupational hygiene studies. The method is based on a combined use of video recordings with measurements taken with real-time monitoring instruments. A commonly used name for VEM is PIMEX. Since PIMEX initially was invented in the mid 1980’s have the method been implemented and developed in a number of countries. With the aim to give an updated picture of how VEM methods are used and to investigate needs for further development have a number of workshops been organised in Finland, UK, the Netherlands, Germany and Austria. Field studies have also been made with the aim to study to what extent the PIMEX method can improve workers motivation to actively take part in actions aimed at workplace improvements.The results from the workshops illustrates clearly that there is an impressive amount of experiences and ideas for the use of VEM within the network of the groups participating in the workshops. The sharing of these experiences between the groups, as well as dissemination of it to wider groups is, however, limited. The field studies made together with a number of welders indicate that their motivation to take part in workplace improvements is improved after the PIMEX intervention. The results are however not totally conclusive and further studies focusing on motivation are called for.It is recommended that strategies for VEM, for interventions in single workplaces, as well as for exposure categorisation and production of training material are further developed. It is also recommended to conduct a research project with the intention of evaluating the effects of the use of VEM as well as to disseminate knowledge about the potential of VEM to occupational hygiene experts and others who may benefit from its use.

Tapping into Floor Staff: Using the knowledge of floor staff to conduct formative evaluations of exhibits in a Canadian science centre

Most science centres in Canada employ science-educated floor staff to motivate visitorsto have fun while enhancing the educational reach of the exhibits. Although bright andsensitive to visitors’ needs, floor staff are rarely consulted in the planning,implementation, and modification phases of an exhibit. Instead, many developmentteams rely on costly third-party evaluations or skip the front-end and formativeevaluations all together, leading to costly errors that could have been avoided. This studywill seek to reveal a correlation between floor staff’s perception of visitors’ interactionswith an exhibit and visitors’ actual experiences. If a correlation exists, a recommendationcould be made to encourage planning teams to include floor staff in the formative andsummative evaluations of an exhibit. This is especially relevant to science centres withlimited budgets and for whom a divide exists between floor staff and management.In this study, a formative evaluation of one exhibit was conducted, measuring both floorstaff’s perceptions of the visitor experience and visitors’ own perceptions of the exhibit.Floor staff were then trained on visitor evaluation methods. A week later, floor staff andvisitors were surveyed a second time on a different exhibit to determine whether anincrease in accuracy existed.The training session increased the specificity of the motivation and comprehensionresponses and the enthusiasm of the staff, but not their ability to predict observedbehaviours with respect to ergonomics, learning indicators, holding power, and successrates. The results revealed that although floor staff underestimated visitors’ success ratesat the exhibits, staff accurately predicted visitors’ behaviours with respect to holdingpower, ergonomics, learning indicators, motivation and comprehension, both before andafter the staff training.

Using locally available components and local knowledge to build sustainable stand-alone power systems

The aim of this paper is to point out benefits as well as disadvantages associated with the use of locally available, not necessarily standardized, components in stand-alone electrical power systems at rural locations. Advantages and challenges arising when the direct involvement in design, construction and maintenance of the power system is reserved to people based in the area of implementation are discussed. The presented research is centered around one particular PV-diesel hybrid system in Tanzania; a case study in which technical and social aspects related to the particular power system are studied.

How single is ‘single’ : some pragmatic reflections on single versus multifaceted interventions to facilitate implementation

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to improve neonatal survival in the Quang Ninh province, Vietnam

BACKGROUND: Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health - Knowledge Into Practice trial evaluated facilitation of community groups (2008-2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30-0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. METHODS: Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. RESULTS: To ensure eight active facilitators over 3 years, 11 Women's Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19-0.73) than control communes (n = 46). CONCLUSIONS: This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups' work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.

Developing leadership in managers to facilitate the implementation of national guideline recommendations : a process evaluation of feasibility and usefulness

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations.

Clinical interventions, implementation interventions, and the potential greyness in between - a discussion paper

Background: There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implementation intervention. This may be caused by a lack of conceptual clarity between 'intervention' and 'implementation', yet at other times by ambiguity in application. We suggest that both the scientific and the clinical communities would benefit from greater clarity; therefore, in this paper, we address the concepts of intervention and implementation, primarily as in clinical interventions and implementation interventions, and explore the grey area in between. Discussion: To begin, we consider the similarities, differences and potential greyness between clinical interventions and implementation interventions through an overview of concepts. This is illustrated with reference to two examples of clinical interventions and implementation intervention studies, including the potential ambiguity in between. We then discuss strategies to explore the hybridity of clinical-implementation intervention studies, including the role of theories, frameworks, models, and reporting guidelines that can be applied to help clarify the clinical and implementation intervention, respectively. Conclusion: Semantics provide opportunities for improved precision in depicting what is 'intervention' and what is 'implementation' in health care research. Further, attention to study design, the use of theory, and adoption of reporting guidelines can assist in distinguishing between the clinical intervention and the implementation intervention. However, certain aspects may remain unclear in analyses of hybrid studies of clinical and implementation interventions. Recognizing this potential greyness can inform further discourse.